First make the pasta. To do this, add the pumpkin, flour, and egg to the bowl of a stand mixer fitted with a dough hook. Mix together until smooth dough forms. If it's too wet, add more flour. Remove dough and cover with plastic to rest for 15 minutes.
Grab a baking sheet and line with flour. When dough is ready, cut into 4 quarters. Grabbing 1 piece, flatten it out with your palm. Using a pasta roller, roll out the dough on the lowest setting. Fold into thirds and then pass through roller again. Pass through one more time to smooth out dough. Then, move pasta roller to setting 3. Pass pasta through roller two times. Move to setting 4 and pass through twice. Place on the floured baking sheet. Repeat with other 3 pieces of dough and dust with flour**look at notes if you don't have pasta roller**
Dust a second baking sheet with flour. Cut each sheet of dough into half width-wise. Dust each side with flour. Pass first sheet through fettuccine cutter. Pinching the noodled in their centerpoint, twirl them into a circle onto dusted baking sheet. Repeat with second half of first sheet and then repeat with the rest of the dough. Set aside while you make the sauce.